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NPI Code Detail

MEDICARE: LESLIE ANN MCGEE

MEDICARE: LESLIE ANN MCGEE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist056.013643IL

General Provider Information

NPI Number : 1659974509
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE ANN MCGEE
Provider Business Mailing Address
First Line : 1021 S EMERALD LN
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-2433
Country : US
Telephone Number : 312-608-4934
Fax Number :
Provider Business Practice Location Address
First Line : 120 N TOWER RD
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-1929
Country : US
Telephone Number : 618-549-3355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2020
Last Update Date : 11/23/2020

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